Abortion

The Lord Bishop of St Albans: To ask Her Majesty’s Government how they intend to ensure greater accuracy in gathering gender-correlated abortion statistics.

Earl Howe: Sex of the fetus is not recorded on the HSA4 forms submitted to the Chief Medical Officer; the gender of the fetus is not known for most abortions.
	The Department’s latest analysis of birth ratios data published in May found no evidence of sex selection taking place in the United Kingdom. However, we will continue to monitor birth ratios and consider any other evidence that comes to light.

Abortion

The Lord Bishop of St Albans: To ask Her Majesty’s Government what protection they are offering to vulnerable women who feel under pressure to have a sex-selective abortion for fear of injury to their physical or mental health should they give birth to a girl.

Earl Howe: Women who present for an abortion should always have the opportunity to speak to a health professional or trained pregnancy counsellor on their own at some point during the consultation to determine the degree of certainty of their decision. Staff will take this opportunity to identify whether there is any pressure to terminate the pregnancy from others. Where pressure or coercion is identified, pathways should be in place to refer the woman for support from specialist services.

Ambulance Services: City of Westminster

Lord Hoyle: To ask Her Majesty’s Government what is their assessment of the current London Ambulance Service response times to life-threatening incidents (category A calls) within the City of Westminster.

Earl Howe: The performance standard for ambulance trusts responding to Category A calls is that an ambulance resource should arrive within eight minutes of the call 75% of the time.
	We understand that this year to date (1 April 2014 -28 November 2014) the London Ambulance Service has achieved a response rate to ‘category A’ calls in Westminster of 69.58%.
	We are providing extra support to the National Health Service – including £50 million to help ambulance trusts with additional demand and help them to return to meeting the standard as quickly as possible.

EU External Trade: Tunisia

Lord Hylton: To ask Her Majesty’s Government whether duties on goods from Tunisia entering the European Union have been eliminated; and if not, to what extent they will be reduced in the coming year.

Lord Deighton: Following the signing of an Association Agreement with the EU in 1995, the import Tariffs on industrial products originating from Tunisia have been eliminated. The same Agreement also resulted in greater liberalisation in the Tariffs on agricultural and fishery products.
	A preparatory process for launching negotiations on a Deep and Comprehensive Free Trade Area (DCFTA) is on-going.

Financial Services: ICT

Lord Kennedy of Southwark: To ask Her Majesty’s Government what representations they are making to the financial services industry to ensure that the information technology infrastructure is fit for purpose.

Lord Deighton: Responsibility for information technology infrastructure in the UK finance sector is primarily for the firms themselves. The Financial Authorities have a role to play in supporting, coordinating and driving change to improve the operational resilience of the sector.
	In addition to on-going supervisory oversight of technology risk within firms by the Authorities, the Financial Conduct Authority (FCA) and Prudential Regulatory Authority (PRA) jointly launched, in October 2014, a review of firms’ critical infrastructure and technology resilience. The review focuses on the most significant UK retail deposit-taking organisations and is expected to conclude in mid-2015.

Financial Services: Regulation

Lord Kennedy of Southwark: To ask Her Majesty’s Government what is their assessment of the rules governing short selling.

Lord Deighton: The rules governing short selling are set out in the Short Selling Regulation (SSR) - a directly applicable EU regulation which entered into
	force on 1 November 2012. Article 45 of the Regulation requires the European Commission to carry out a review of the Regulation.
	The European Commission published a report in December 2013 setting out its findings. That review concluded that “…it is too early, based on available evidence, to draw firm conclusions on the operation of the SSR framework which would warrant a revision of the legislation at this stage”. The report concludes that a further review could be carried out based on more empirical evidence by 2016.

Floods: Somerset

Lord Patten: To ask Her Majesty’s Government whether they intend to construct the River Parrett Barrier near Bridgewater to help protect the Somerset Levels from further flooding.

Lord De Mauley: The main purpose of constructing a tidal surge barrier on the River Parrett would be to protect Bridgwater from tidal flooding. This would provide some benefit to the Somerset Levels and Moors because pumping would be able to continue at the peaks of the very highest tides should they coincide with a fluvial flood event.
	A tidal surge barrier was originally planned for delivery between 2030 and 2050 as described in Sedgemoor District Council’s Core Strategy.
	The 20-year Somerset Levels and Moors Action Plan identified potential benefits of accelerating this delivery. Subject to the availability of finance and the required consents being granted, experience from similar projects suggests it would be feasible to complete construction of the barrier within eight years.

Garages and Petrol Stations

Lord Roberts of Llandudno: To ask Her Majesty’s Government what action they are taking to ensure that petrol stations are located at sufficiently regular points along United Kingdom roads.

Baroness Verma: DECC published a report from Deloitte LLP in December 2012, ‘Study of the UK petroleum retail market’, which considered long term changes to the retail market for road fuels in the UK, and the implications of these changes to our energy resilience. The market has changed significantly over the last decade. However, the findings of the report do not suggest that changes to the size and shape of the retail market for road fuels have significantly reduced the access of UK motorists to a local supply of fuel. The report found that in 2011, 98% of postcode sectors had a petrol filling station within a 10 minute driving time, and 92% had more than two within the same travel time.
	Decisions on the location of individual petrol filling stations are for local planning authorities to make. As the market develops we will continue to monitor the situation.

Garages and Petrol Stations

Lord Roberts of Llandudno: To ask Her Majesty’s Government what authorisation is necessary before a petrol station can be closed.

Baroness Verma: No specific authorisation is required to close a petrol station.

Government Departments: Staff

Lord Sharkey: To ask Her Majesty’s Government what is the number and cost, in both absolute terms and as a percentage of the total departmental workforce, of non-payroll staff in the Home Office for each of the last 18 months for which data are available.

Lord Bates: The number and cost of non-payroll staff in the Home Office in absolute terms and as a percentage of the total workforce for each of the last 18 months are set out in Table 1 and Table 2 below.
	Over the period the number of non payroll staff each month has varied between 2,175 and 2,850 and their cost between £3.2m and £13m.
	As a percentage of total workforce, the number of non payroll staff has varied between 7.7% and 9.5% and their cost between 3.6% and 11.5%.
	
		
			 Table 1 - Home Office Headcount Full Time Equivalent for April 2013 to October 2014 
			  HC FTE  
			 Headcount Marker Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13  
			 Non Payroll 2,175.48 2,331.61 2,439.47 2,268.09 2,473.57 2,371.27 2,563.46 2,603.63 2,705.11  
			 Departmental Total 28,250.39 28,443.71 28,590.66 28,852.87 29,073.54 29,008.95 29,263.92 29,329.86 29,451.95  
			 Non Payroll % of total workforce 7.7% 8.2% 8.5% 7.9% 8.5% 8.2% 8.8% 8.9% 9.2%  
		
	
	
		
			  HC FTE  
			 Headcount Marker Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 
			 Non Payroll 2,743.15 2,825.95 2,832.39 2,850.05 2,715.64 2,792.27 2,759.52 2,844.01 2,815.21 2,649.04 
			 Departmental Total 29,402.04 29,675.40 29,879.41 30,028.32 30,052.15 30,346.49 30,609.09 30,829.62 31,269.43 31,252.67 
			 Non Payroll % of total workforce 9.3% 9.5% 9.5% 9.5% 9.0% 9.2% 9.0% 9.2% 9.0% 8.5% 
		
	
	Data Source: Data View - the Home Office’s single source of Office for National Statistics compliant monthly snapshot corporate Human Resources data.
	Period Covered: 1st April 2013 to 31st October 2014.
	Extraction Date: 1st day of each following month.
	Organisational Coverage: Figures include core Home Office (including Border Force, UK Visas & Immigration and Immigration Enforcement) and the Executive Agencies; Her Majesty's Passport Office and the National Fraud Authority
	Employee Coverage: Departmental total is based on headcount FTE of all paid, unpaid civil servants and non civil servants who were current on the last day of each month. Non payroll data are non civil servants which includes Agency, Contractor non paid and Incoming Secondment Unpaid (Non OGD)
	
		
			 Table 2 - Cost of payroll and non-payroll staff April 2013 to October 2014 
			 Cost (£m) Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13  
			 Payroll staff 88.2 87.9 87.6 87.7 88.1 87.5 87.3 127.7 89.2  
			 Non-payroll staff 4.2 3.3 5.9 6.7 3.6 5.7 5.3 6.8 8.2  
			 Grand Total 92.4 91.2 93.5 94.4 91.6 93.2 92.7 134.6 97.4  
			 Non-payroll % of total cost 4.5% 3.6% 6.3% 7.1% 3.9% 6.1% 5.8% 5.1% 8.4%  
			 Cost (£m) Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 
			 Payroll staff 89.7 89.9 99.9 94.4 90.4 93.0 96.8 96.6 96.9 95.3 
			 Non-payroll staff 7.6 9.3 13.0 6.2 6.1 6.5 7.3 6.1 5.5 8.2 
			 Grand Total 97.3 99.2 112.9 100.6 96.5 99.5 104.2 102.8 102.4 103.5 
			 Non-payroll % of total cost 7.8% 9.4% 11.5% 6.2% 6.3% 6.5% 7.0% 6.0% 5.4% 7.9% 
		
	
	Data Source: Data View - the Home Office’s single source of Office for National Statistics compliant monthly snapshot corporate Human Resources data.
	Period Covered: 1st April 2013 to 31st October 2014.
	Extraction Date: 1st of each following month.
	Organisational Coverage: Figures include core Home Office (including Border Force, UK Visas & Immigration and Immigration Enforcement) and the Executive Agencies; Her Majesty's Passport Office and the National Fraud Authority
	Employee Coverage: Payroll staff data is based on cost of all paid and unpaid civil servants, who were current on the last day of each month. Non-payroll staff costs are based on contingent labour and consultants/consultancy and does not include Incoming Secondments (Non OGD).

Immigration

Lord Turnberg: To ask Her Majesty’s Government what calculations they have made of the fiscal impact of immigration into the United Kingdom.

Lord Deighton: In order to inform policy making, the government reviews and notes the wider evidence on the economic and fiscal impacts of immigration on an ongoing basis. This evidence base includes the wider academic literature, and a range of reports commissioned or produced by the government looking at specific impacts, for example those produced by the independent Migration Advisory Committee. In addition, policies that influence migration are assessed using the government's impact assessment process which models the economic impact of the policy change using assumptions based on a range of evidence and the academic literature. Home Office Impact Assessments are published on gov.uk.

Medical Records

The Countess of Mar: To ask Her Majesty’s Government whether clinical commissioning groups, general practitioner surgeries or any other National Health Service bodies have the legal right to provide insurance companies, or anyone else outside the National Health Service, with patients’ details, including their medical details; if so, which legislation permits such action; and, if any payment is received for supplying such information, to whom it is made.

Earl Howe: In the vast majority of cases National Health Service organisations may only provide confidential information about a patient to insurance companies and other third parties such as employers with the explicit consent of the patient. However, there may be a small number of cases where disclosure may take place without seeking consent, for example where there is a court order. Healthcare professionals who supply medical reports to insurance companies and employers may charge a fee for doing so; NHS organisations that supply copies of medical records may charge a fee that covers their costs.

Mental Health Services: Nurses

Lord Bradley: To ask Her Majesty’s Government how many mental health nurses were employed in (1) community services, and (2) in-patient services, in the National Health Service in each of the last five years.

Earl Howe: Mental health nurses are not identified separately in the Health and Social Care Information Centre’s (HSCIC) workforce statistics. Mental health nurses work predominantly in psychiatric services but also across a range of settings and the independent sector.
	The following table shows the full time equivalent number of nurses who work in the community psychiatry and other psychiatry areas of work in the National Health Service in each of the last five years. The data is taken from the HSCIC’s monthly workforce statistics and is for 31 August in each year.
	
		
			 Nurses working in Community Psychiatry and Other Psychiatry August 2010 to August 2014 
			  Number of Full-time Equivalent Nurses in England as at 31 August 
			 Area of Work 2010 2011 2012 2013 2014 
			 Community Psychiatry 15,999 15,572 15,677 15,651 15,404 
			 Other Psychiatry 25,372 24,517 23,649 22,977 22,405 
		
	
	Source: Health and Social Care Information Centre

Multiple Births

Lord Alton of Liverpool: To ask Her Majesty’s Government, further to the Written Answers by Baroness Kinnock of Holyhead on 8 April 2010 (HL3233 and HL3235) and by Earl Howe on 17 November (HL2643), what assessment they have made of the outcomes following foetal reduction in cases of multiple pregnancy in China compared to England and Wales over the past decade; to what extent they consider
	any such differences to be due to China's one-child policy or other factors; and when they last made representations to the government of China about the one-child policy.

Earl Howe: The Department publishes Abortion Statistics, England and Wales annually. Information on selective terminations in cases of multiple pregnancy can be found at 2.29 on p16 of the Abortion Statistics for England and Wales: 2013; a copy has already been placed in the library.
	No assessment has been made of selective reduction abortions performed in other countries, including China, compared to those in England and Wales.
	The Foreign and Commonwealth Office has a broad range of human rights concerns in China which is raised regularly with the Chinese authorities. The Foreign and Commonwealth Office has raised specific concerns around the one-child policy during the UK-China Human Rights Dialogue on 19-20 May 2014. It also highlighted the issue, alongside other women’s rights concerns, in the China section of the Foreign and Commonwealth Office’s Annual Report on Human Rights and Democracy :
	www.gov.uk/government/publications/china-country-of-concern/china-country-of-concern
	A copy has already been placed in the library.

National Income: South West

Baroness Royall of Blaisdon: To ask Her Majesty’s Government how much revenue (1) the South West of England, and (2) Bristol, have been responsible for as a percentage of the United Kingdom's gross national product since May 2010.

Lord Wallace of Saltaire: The information requested falls within the responsibility of the UK Statistics Authority. I have asked the Authority to reply.
	Letter from Nick Vaughan, Director, National Accounts & Economic Statistics, Office for National Statistics to Baroness Royall of Blaisdon dated December 2014.
	On behalf of the Director General for the Office for National Statistics (ONS), I have been asked to reply to your recent Parliamentary Question asking Her Majesty’s Government how much revenue (1) the South West of England, and (2) Bristol, have been responsible for as a percentage of the United Kingdom’s gross national product since May 2010. (HL3066)
	ONS does not produce regional estimates of Gross National Product (GNP), which is now more commonly referred to as Gross National Income (GNI), but does produce annual regional estimates of Gross Value Added (GVA) for geographical areas according to the European classification Nomenclature of Territorial Units for Statistics (NUTS). GNI includes the balance of employment, property and entrepreneurial income
	with the rest of the world, whereas GVA measured using the income approach includes only the income earned by resident individuals and corporations in the production of goods and services.
	GVA measured using the income approach – GVA(I) - is available at current basic prices for regions, sub-regions and local areas. Note that in these estimates income is allocated to the area where people work and not where they live. Current basic prices exclude taxes and subsidies on products that would be included in estimates of Gross Domestic Product (GDP) at current market prices. The table below shows GVA(I) for the South West of England region and City of Bristol local area and their share in the UK total for 2010, 2011 and 2012. Only current price estimates of GVA(I) are available because changes in income cannot readily be split between changes in prices and changes in volume.
	
		
			  2010 2011 2012 
			 South West
			 GVA(I) (£million) 100,372 100,392 101,576 
			 GVA(I) as a percentage of UK GVA(I) 7.6% 7.4% 7.3% 
			 Index of real GVA(P) (2010 = 100) 100 99.4 n/a 
			 Bristol, City of
			 GVA(I) (£million) 11924 11550 11740 
			 GVA(I) as a percentage of UK GVA(I) 0.9% 0.8% 0.8 
		
	
	These figures are taken from:
	Regional GVA (Income Approach) statistical bulletin published in July 2014
	http://www.ons.gov.uk/ons/rel/regional-accounts/regional-gross-value-added--income-approach-/december-2013/stb-regional-gva-2012.html

Network Rail

Lord Kennedy of Southwark: To ask Her Majesty’s Government what is their assessment of Network Rail's ability to deliver infrastructure projects.

Baroness Kramer: The independent regulator, the Office of Rail Regulation (ORR), is responsible for overseeing and enforcing Network Rail’s obligations, including the delivery of infrastructure projects. On 20 November ORR published its assessment, in the ‘Network Rail Monitor’, of Network Rail’s performance in the first two quarters of Control Period 5 (2014-19) covering the period 1 April to 11 October 2014. ORR reported that following a period of relatively successful delivery in Control Period 4 (2009-14) Network Rail has not made the expected progress in the early stages of certain enhancement projects in Control Period 5. ORR has asked Network Rail to produce an improvement
	plan to demonstrate how it will change its approach to make up for these delays and will hold Network Rail to account for its delivery. DfT is working extremely closely with ORR and Network Rail to ensure that the vital passenger benefits in the Rail Investment Strategy are delivered.

NHS: Pay

Lord Stoddart of Swindon: To ask Her Majesty’s Government whether they place a limit on the daily payment of doctors, nurses and other professionally qualified staff hired by the National Health Service from the private sector.

Earl Howe: It is not for the Department to place a limit on the daily payment of doctors, nurses and other professionally qualified staff hired by the National Health Service from the private sector.
	The Department expects trusts to have a strong grip on their finances, and manage their contract and agency staffing spend responsibly through effective and efficient workforce planning and management.
	Trusts have access to these staff at appropriate prices through frameworks managed by the Crown Commercial Service and the 4 NHS procurement hubs and we are working with, for example, Monitor and the NHS Trust Development Authority, to encourage trusts to use these frameworks.
	Following the Francis report many trusts have increased their spend on temporary staffing to meet safe staffing levels.
	Where appropriate, we shall also be using the newly published section 42 guidance, for trusts requiring financial support, to expect those trusts to reduce their spending on agency staffing over the course of the next financial year.

Pancreatic Cancer: Drugs

Baroness Masham of Ilton: To ask Her Majesty’s Government, in the light of the proposed re-evaluation of treatments on the Cancer Drugs Fund list, what assurances they can provide to patients with pancreatic cancer that the latest medicines will continue to be made available to them on the National Health Service.

Earl Howe: The Government is committed to ensuring that patients have access to effective treatments, including those for pancreatic cancer, on terms that represent value to the National Health Service and the taxpayer.
	The National Institute for Health and Care Excellence (NICE) is the independent body responsible for providing advice to the NHS on the clinical and cost-effectiveness of health technologies.
	NICE has recommended gemcitabine as a treatment option for pancreatic cancer in technology appraisal guidance published in May 2001, subject to certain clinical criteria, and has been asked to appraise a number of other pancreatic cancer drugs. NHS commissioners are legally required to fund treatments recommended by NICE technology appraisal guidance.
	Where a pancreatic cancer drug is not routinely available on the NHS, patients may be able to access it through the Cancer Drugs Fund.
	NHS England’s Cancer Drugs Fund panel plans to assess, on the basis of the latest evidence, whether certain drugs, including Abraxane (albumin bound paclitaxel) for advanced pancreatic cancer, should continue to be made routinely available to new patients through the Fund and to consider a number of new drugs for potential addition to the Fund.
	NHS England has assured the Department that no patient whose treatment is currently being funded through the Fund will have funding withdrawn, as long as it is clinically appropriate that they continue to receive that treatment. In addition, no drug will be removed from the Fund where it is the only therapy for that condition.
	We are committed to maintaining the Cancer Drugs Fund until the end of March 2016. We will carefully consider with NHS England what arrangements should be put in place for the long term.
	Surgery, radiotherapy and chemotherapy treatments that may be used for pancreatic cancer are commissioned by NHS England. NHS England’s pancreatic cancer service specification clearly defines what it expects to be in place for providers to offer evidence-based, safe and effective pancreatic cancer services.
	NHS England has also committed to make up to £6 million available over the next three years to support six trials by Cancer Research UK - one of which will be on pancreatic cancer - into the use of Stereotactic Ablative Radiotherapy (SABR), an innovative radiotherapy treatment. This will allow patients to receive SABR treatment where clinicians think they could benefit. At the same time doctors can fully assess the effectiveness of this treatment so that, if it proves to be effective, it will be available for patients on the NHS where appropriate.
	We are also commissioning an external review of the pathways for the development, assessment, and adoption of innovative medicines and medical technology. This review will consider how to speed up access for NHS patients to cost-effective new diagnostics, medicines and devices.

Pancreatic Cancer: Drugs

Baroness Masham of Ilton: To ask Her Majesty’s Government what action they are taking to ensure that all treatments for advanced pancreatic cancer shown to be effective are made available to patients on the National Health Service.

Earl Howe: The Government is committed to ensuring that patients have access to effective treatments, including those for pancreatic cancer, on terms that represent value to the National Health Service and the taxpayer.
	The National Institute for Health and Care Excellence (NICE) is the independent body responsible for providing advice to the NHS on the clinical and cost-effectiveness of health technologies.
	NICE has recommended gemcitabine as a treatment option for pancreatic cancer in technology appraisal guidance published in May 2001, subject to certain clinical criteria, and has been asked to appraise a number of other pancreatic cancer drugs. NHS commissioners are legally required to fund treatments recommended by NICE technology appraisal guidance.
	Where a pancreatic cancer drug is not routinely available on the NHS, patients may be able to access it through the Cancer Drugs Fund.
	NHS England’s Cancer Drugs Fund panel plans to assess, on the basis of the latest evidence, whether certain drugs, including Abraxane (albumin bound paclitaxel) for advanced pancreatic cancer, should continue to be made routinely available to new patients through the Fund and to consider a number of new drugs for potential addition to the Fund.
	NHS England has assured the Department that no patient whose treatment is currently being funded through the Fund will have funding withdrawn, as long as it is clinically appropriate that they continue to receive that treatment. In addition, no drug will be removed from the Fund where it is the only therapy for that condition.
	We are committed to maintaining the Cancer Drugs Fund until the end of March 2016. We will carefully consider with NHS England what arrangements should be put in place for the long term.
	Surgery, radiotherapy and chemotherapy treatments that may be used for pancreatic cancer are commissioned by NHS England. NHS England’s pancreatic cancer service specification clearly defines what it expects to be in place for providers to offer evidence-based, safe and effective pancreatic cancer services.
	NHS England has also committed to make up to £6 million available over the next three years to support six trials by Cancer Research UK - one of which will be on pancreatic cancer - into the use of Stereotactic Ablative Radiotherapy (SABR), an innovative radiotherapy treatment. This will allow patients to receive SABR treatment where clinicians think they could benefit. At the same time doctors can fully assess the effectiveness of this treatment so that, if it proves to be effective, it will be available for patients on the NHS where appropriate.
	We are also commissioning an external review of the pathways for the development, assessment, and adoption of innovative medicines and medical technology. This review will consider how to speed up access for NHS patients to cost-effective new diagnostics, medicines and devices.